Just joking!

Have you ever seen or heard someone say something along the lines of "I'm going to kill myself, this sucks so bad. Ha ha, just joking!"? I know I have, and it bothers me. Before anyone says "you're being too sensitive" or "lighten up, (s)he is just spouting off.", let me explain why this issue bugs me.

Suicide is no light matter. It's not something to laugh or joke about. It's not funny or humorous. People kill themselves every single day, for a variety of reasons. It's serious. Just how serious is it? Let's take a look at some numbers.

• According to a link from the NIMH (National Institute of Mental Health), "In 2007, it was the tenth leading cause of death in the U.S., accounting for 34,598 deaths. The overall rate was 11.3 suicides per 100,000 people. An estimated 11 attempted suicides occur per every suicide death.". So, in 2007, not only did 34,598 people successfully take their own lives, but doing the math, it's estimated that 380,578 people attempted suicide. *Maybe* some of those 380,578 people now consider it a joking matter, but I find it hard to believe that those 34,598 peoples loved ones consider it something to joke about.
• The previous NIMH link was statistics from 2007. According to this link from the CDC (Centers for Disease Control and Prevention), the number of suicide deaths in 2010 was 38,364, with suicide still sitting at the #10 spot for causes of death. 
• There aren't any good statistics for suicide related deaths among women with PPD because PPD isn't tracked nearly as closely as it should be in the US. The CDC estimates that am average of 8% of moms end up with PPD, and some of those women are killing themselves. Katherine Stone of Postpartum Progress estimates that the number may be more likely to be an average of 20% of women ending up with PPD each year
• According to this article from the NPR, the number of suicide deaths in the U.S. military in 2012 was 349 (a new record for the military), higher than the number of deaths among Americans who died in combat in Afghanistan in 2012.

The reasons why people kill themselves (or attempt to kill themselves) are varied. Mental illness, terminal illness, difficult situations that leave them feeling helpless and hopeless, and so many more. I've never killed myself (yes, you may call me Captain Obvious) but I was hospitalized twice with suicidal ideations and intrusive thoughts after my first baby was born. There was absolutely nothing funny about it then and I still (almost 4 years later) don't find any humor in people "just joking" about wanting to kill themselves. It's not a laughing matter that people are in that much pain (mental/emotional or physical). It's not a laughing matter that their family and friends have to deal with the pain and anguish of losing a loved one to suicide. There's nothing to laugh about. It's not a lighthearted subject.

Not only is it a serious and painful matter for those who (in whatever capacity) are dealing with suicidal ideations, attempts, or successes, making "jokes" about suicide contributes to the stigma around not only suicide but mental health and seeking help for mental illnesses. When people joke about suicide, it's hard for the people around them to ask for help (who wants to risk being laughed at, dismissed, and possibly be made the butt of a "joke"?). When people joke about suicide, it can be hard to recognize when they're no longer joking (ever heard the story of the boy who cried wolf?). When people joke about suicide, it contributes to the stigma surrounding not just suicide but mental illness in general.

The statistics I included in this post are specific to the United States of America, but the sentiment of "Suicide is not something to joke about" is most certainly not. I personally have friends around the world who have suffered/are currently fighting mental health issues. Except for the statistics, everything I've said here applies to you no matter where you live, no matter where you're from. The fact that suicide is not something to make light of  doesn't change based on location. Please, take it seriously. If you see or hear someone "just joking" about killing themselves, take it seriously. You could save lives.

Pink is everywhere.

In honor of Strong Start Day, I'm doing a second blog post. I was inspired when I received yet another private message on Facebook requesting that all of the recipients participate in a game where the idea is to use a particular set of criteria to make up the status and then specifically NOT tell any males what the status is about when they ask. Here's the text of the one I've been getting the most often this year.

"Okay ladies it's that time of year again, in support of breast cancer awareness!! So, we all remember last year's game of writing a color as your status?.....or the way we like to have our handbag handy? Well this year, it's slightly different. You need to write your shoe size ( just the number) followed by the word 'inches' and how long it takes to do your hair... Remember last year so many people took part it made national news and, the constant updating of status reminded everyone why we're doing this and helped raise awareness!! Do NOT tell any males what the status means, keep them guessing!! And please copy and paste (in inbox) this to all your female friends to see if we can make a bigger fuss this year than last year!!! I did my part... now it's YOUR turn! Go on ladies...and let's have all the men wonder."

Being secretive about it and not telling males what your status means doesn't raise awareness. My recommendation would be that if you truly want to raise awareness, post statistics that make women aware that it could realistically happen to them, stories that illustrate that it is no respecter of persons and strikes people of all walks of life, facts (ex: men can get breast cancer too!!!), reminders of the importance of doing self-exams and what to do if you find a lump, current recommendations for when you should get mammograms and how often, risk factors, etc.


Beyond that though, where are the awareness efforts and widespread status games in the name of raising awareness for postpartum mood and anxiety disorders? Whenever I question the breast cancer awareness chain message status games and ask "Why do these not get sent for other forms of cancer?", the answer I get is usually that breast cancer is more prevalent, and more easily detected, than other forms of cancer. That may be true for breast cancer vs. other forms of cancer (although I still don't think it's a valid reason to totally ignore other forms and, in fact, is a perfect example of why more attention should be given to raising awareness about thyroid cancer, cervical cancer, prostate cancer, ovarian cancer, etc.). However, it's certainly not true for postpartum mood and anxiety disorders.

As I wrote about in my earlier Strong Start Day 2012 post, Katherine Stone of Postpartum Progress estimates that each year, in the United States of America alone, the number of women who suffer PostPartum Depression is approximately 950,000 women; she also estimates that approximately 1.3 million women suffer from postpartum mood and anxiety disorders, expanding from PPD to include those such as PostPartum OCD and PostPartum Psychosis. That's more women than are diagnosed annually with Breast Cancer (the National Cancer Institute puts that number at approximately 230,000 women).

PostPartum Mood and Anxiety Disorders can be diagnosed easily and early, but it requires education and awareness as to the realities and symptoms, and a departure from the stigma and myths that are so prevalent in today's society. Breast Cancer Awareness is a huge deal in the United States. Stores sell special pink merchandise to benefit various programs and groups. Sports teams have special jerseys. Pink is everywhere. I have no issue with the fact that people want to raise awareness of breast cancer. The issue I have is that sometimes it seems to be at the exclusion of other conditions and illnesses.

Someone asked me this evening why I would make it a contest. I don't see it as a contest at all. What I do see it as is yet another sign of the appalling lack of education and awareness regarding postpartum mood disorders. If the numbers Katherine has estimated are correct, a woman is more than 5 times more likely to suffer from postpartum mood and anxiety disorders (whether one or more) than she is to be diagnosed with breast cancer. And even worse, that doesn't negate the risk of breast cancer, you can obviously end up "double tapped".

All the women I know are very aware of breast cancer. Many, though, are not nearly as aware of the symptoms and realities of PPMAD. That bothers me to no end because I know first hand exactly how devastating and crippling they can be. I was one of the lucky ones. I was able to get treatment and had the support my of family and the few friends who knew what I was dealing with. I almost killed myself but I didn't. Too many women don't get that treatment. Some of them don't know it can be treated. Some keep quiet out of fear, guilt and shame. Some don't have access to resources to get treatment. Some don't have insurance that covers it and some don't have insurance at all. Some have no idea that PPMAD exist. 

These are some of the reasons why I speak up. These are some of the reasons why I'm so vocal in my support of education and awareness. These are some of the reasons why I participate in Strong Start Day in hopes of raising money for Postpartum Progress to be able to expand their resources and efforts for education and awareness, to be able to help and support more women in more ways (Katherine Stone has 6 other great reasons). These are some of the reasons why I'm asking people to join me in supporting Postpartum Progress. Pink is everywhere in America and I want to see that same level of awareness for PPMAD.

Happy 100th Blog Post and Happy Strong Start Day 2012

Today I have hit a milestone in my blogging. This is the 100th post that I've published to Through The Tunnel. My first post was on December 14, 2009. I had recently found out that my pregnancy with Elizabeth had caused me to develop hypothyroidism. Depression can be a symptom of hypothyroidism and the doctor and I were confident that 

if we could get my thyroid levels back within normal limits the PPD would clear up.

Knowing that there was a medical reason for the PPD was freeing for me; it was a huge relief to know that there was something we could do to actually fix the problem. I literally cried tears of joy when the nurse called and told me that my lab results showed my TSH and T-4 levels as being so far outside the range of Normal Limits that my thyroid had practically stopped working at all. 

I started taking Synthroid and sure enough, within just a few weeks there was a noticeable difference. 3 months of thyroid medication did what 6 months of antidepressants, antianxiety medication, and sleep aids had not and I was able to come off of all my medication except, of course, the Synthroid. I can't express how much relief I felt at hearing the doctor say that I was "considered successfully treated". 

When I received that diagnosis of PostPartum Depression and was hospitalized, the shame and guilt that I felt were overwhelming. I was sure that I would never be able to tell anyone my terrible secret. I limited the people who knew to only those who HAD to know. I asked my parents not to tell anyone else in the family. My husband, being in the military, had to tell his Chain of Command, there was no way around that, but I asked that the information be limited to only those who absolutely HAD to know. I was terrified that people would find out and look at me differently, that they would be horrified and think the same thing I did, that I was a terrible wife and mother, that I was a failure. I was sure that nobody I knew had ever gone through anything like this and there was nobody else who would understand.

I know differently now. I know that none of what happened was my fault and that there was nothing to be ashamed of, that it didn't make me a failure. I know that there are other people who have been through the same thing. Some of those are people I know in person. Some of them are people I know solely from online interactions but I love and respect them just as much as anyone I've ever met in real life.

One of those people is Katherine Stone. Katherine is an absolutely wonderful person, and one of the strongest people I know. From her website,

Katherine Stone (@postpartumprog) is the founder and editor of Postpartum Progress, the leading blog on postpartum depression, and a parenting columnist for Disney’s Babble.com.  She’s also the founder of Postpartum Progress Inc., a national nonprofit focused on vastly improving support for women with perinatal mood and anxiety disorders.

Katherine and PostPartum Progress were my inspiration for starting my own blog about my journey. PostPartum Progress was a wonderful resource for me when I was in the midst of my PPD and has continued to be a wealth of information; I frequently link the blog posts on my Facebook and Twitter because they are so well written and have such an important message. PostPartum Progress is where I found the link to My PostPartum Voice, which led me to the Twitter community #PPDChat and a whole world of support that I never dreamed existed.

The work that PostPartum Progress does is beyond calculable value. In a post titled How Many Women Get PostPartum Depression? The Statistics on PPD, Katherine estimates that each year in the United States of America alone, the number of women who suffer PostPartum Depression is approximately 950,000 women with approximately 1.3 million women suffering from postpartum mood and anxiety disorders, expanding from PPD to include those such as PostPartum OCD and PostPartum Psychosis. That's more women than are diagnosed annually with Breast Cancer (the National Cancer Institute puts that number at approximately 230,000 women). October is well known for being Breast Cancer Awareness month with chain stores selling pink merchandise to benefit breast cancer research and awareness, teams like the Dallas Cowboys Cheerleaders doing special routines with special costumes for BCA, celebrities doing major breast cancer awareness campaigns, and so much more. Breast Cancer Awareness is well and good but where are the major awareness, education, and outreach campaigns for PPMD?

The shame and guilt that I felt, that so many other women feel every day, is largely due to the lack of public awareness and education, to the stigma, misconceptions, misunderstandings, and myths that are so prevalent in our society. PostPartum Progress is working actively to combat that and change the tide, to make people aware of the realities of PPMD and to let women like me know that we're not alone. When you feel like you're floating alone at sea, struggling to keep your head above water, that realization is like a life preserver being thrown to you by the Coast Guard to keep you afloat until the rescue swimmers can get you to safety.

PostPartum Progress can't do it alone though. Last year, Katherine came up with the idea to do Strong Start Day. The idea behind Strong Start Day is that since October 5 is the day of the year that, statistically, the most babies are born, it makes sense to have that  be a day to focus fundraising efforts towards raising money to help PostPartum Progress expand their capabilities and improve their resources so that they can help give more new moms and babies a strong start.

PostPartum Progress helps and supports so many women and families. It seems appropriate to me to dedicate my 100th blog post to supporting someone who has supported me and supports so many other women who are in similar situations or worse. I'm asking that my friends, family, and anyone else who's reading consider supporting PostPartum Progress. As stated in her post about Strong Start Day 2012, 

My goal for Strong Start Day 2012 is to raise enough money to allow Postpartum Progress Inc. to translate what we have done online into offline materials. I am asked all the time by nurses, doulas, physicians’ offices and if they can use the words we have created here to help mothers understand what they’re going through and that they can get better. They want our words because they believe we reach moms in a safe and accessible way. They want and need materials from us, materials that I have yet been able to give them because I haven’t had the funding to create them. Not every new mom is online. Plenty don’t have Twitter accounts. They aren’t on Pinterest. We need more ways to reach moms who need help.

This Friday, October 5th, is the 2nd annual Strong Start Day for Postpartum Progress. We only ask for your help one day a year because we don’t believe in bombarding our friends with continual requests for donations. I know I get zillions of them — in my inbox, my mailbox. We want this one day — October 5th, the day each year on which more babies are born than any other — to be the one day you are reminded to give whatever support you can to Postpartum Progress, and to encourage everyone who loves you and who believes moms should know more about postpartum depression to support us too. I hope you’ll join us.

If you'd like to donate to PostPartum Progress, you can follow the link or click the red button below. I hope you'll consider joining me in donating to this cause that has meant so much to me and to so many other women. Regardless of whether you can donate monetarily, please spread the word in some way, whether it's sharing the link to this blog post or sharing Katherine's links.

Over the last 3 years and 100 blog posts, so much has changed for me. New babies, a cross-country move, and so much more. What hasn't changed is that many many many other women are suffering, some in silence, from PPMD, and that PostPartum Progress is there to provide support, education, and a variety of resources. What does need to change is the lack of awareness in today's society. Today, we have the chance to help power that change. Will you join me in supporting Katherine and PostPartum Progress?

P.S.
As another show of support, if you're reading this, will you leave a comment below encouraging Katherine in her efforts to advocate for Warrior Moms everywhere?

What's the big deal about PostPartum Depression?

I've heard people ask "What's the big deal about PostPartum Depression?" and while part of me thinks "How can anyone say that?", part of me knows that that question comes from a place of ignorance. I speak from experience when I say that it can be hard to understand and hard to be sympathetic when you've never dealt with PPD or a loved one with PPD. Prior to my own experience with it I would hear the stories about the extreme cases (think Andrea Yates) and think "That's just an excuse". Maybe it is an excuse for some people but for far too many, it's not. PostPartum Mood Disorders don't have to cause someone to kill or try to kill, but they most certainly are something to be taken seriously.

PostPartum Depression is not a "bad mood". It's not a matter of "choosing to wallow". It's not indicative of someone who "Needs to pray harder" or "Should go to church more often". PostPartum Depression is a legitimate medical condition that must be treated by a qualified medical professional. In a blog entry titled How Many Women Get Postpartum Depression? The Statistics of PPD , Katherine Stone of Postpartum Progress addresses the sobering statistics.

Quick, guess which number is higher: the number of people who sprain an ankle each year, the number of people who have a stroke, or the number of women who experience postpartum depression?

PPD. Surprised?

In so many books, articles and news programs, you hear the statistic — approximately 10 to 15% of women suffer from postpartum mood disorders (PPMDs), including postpartum depression (PPD), postpartum anxiety/OCD and postpartum psychosis. What bothers me about that statistic is that it holds no meaning for most people, and because of that I think these illnesses get much less funding and attention than so many of the other prevalent illnesses that strike Americans. As a result, I decided to do a bit of quick, non-scientific research to look at the real numbers and to help people understand the real impact that postpartum depression is having on the women of our country.

There were approximately 4.3 million live births in the United States in 2007. This statistic does not include fetal losses, including miscarriages and stillbirths. The National Vital Statistics Report indicates that the total number of clinically recognized pregnancies is around 6.4 million. This is important to know, because all postpartum women are susceptible to postpartum depression, regardless of the pregnancy’s outcome.

So let’s split the difference between the high (20%) and low estimates of PPD (11%) and say that an average of 15% of all postpartum women in the US suffer, as the CDC reported in its 2008 PRAMS research. And let’s use the number of clinically recognized pregnancies and not live births. This would mean that each year approximately 950,000 women are suffering postpartum depression.

BUT, did you know the CDC’s research only reflected self-reported cases of postpartum depression? How many women do you think did not mention they had PPD out of fear or shame? Should we increase the estimate of sufferers to 17% or 20%?

ALSO, these numbers don’t take into account women who may have suffered other perinatal mood and anxiety disorders like PPOCD or postpartum psychosis. Should that make the numbers go even higher?

I’d argue that the average number of new mothers who experience perinatal mood and anxiety disorders is more likely in the 20% range, which would mean around 1.3 million annually.

How does that compare with the incidence among women of other major diseases in America?

• Each year fewer women — approximately 800,000 — will get diabetes. (Nat’l Diabetes Information Clearinghouse)
• Each year about 300,000 women suffer a stroke. (Centers for Disease Control)
• Each year approximately 230,000 women are diagnosed with breast cancer. (National Cancer Institute)

In fact, more mothers will suffer from postpartum depression and related illnesses this year than the combined number of new cases for both sexes of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and epilepsy. This is not to minimize these other terrible diseases, of course. I simply want to illustrate just how prevalent postpartum mood & anxiety disorders are.

Dr. Ruta Nonacs of Massachusetts General Hospital and Harvard Medical School adds, “Postpartum depression is far more common than gestational diabetes. All women receiving prenatal care are screened for diabetes, but how many pregnant and postpartum women are screened for depression? PPD is also more common than preterm labor, low birth weight, pre-eclampsia and high blood pressure; in other words, PPD is the most common complication associated with pregnancy and childbirth.”

Let me leave you with one last thought: More moms will suffer from PPD than men will be diagnosed with new cases of impotence (approx. 600,000) this year. Yet you wouldn’t know it, considering the overabundance of erectile dysfunction (ED) ads and people falling all over themselves to discuss ED openly. Why doesn’t PPD get the same attention from pharmaceutical companies?

Why doesn’t society work as hard to eliminate the stigma of PPD? Why aren’t more corporations and foundations concerned about PPD and supporting awareness campaigns?

This really is a big problem, and deserves much more attention than it’s getting.

If ever there were chilling statistics, I think this makes the cut with no problem. Making it worse, an additional statistic is that only an estimated 15% of those women will receive professional treatment. That means that (going by the numbers laid out above) a estimated 1,133,334 women will suffer n silence, will go without help. Still wondering why all the fuss? 

My experience with PPD was that it made me a totally different person and not in a good way. I spent my days sitting in a rocking chair holding my baby and staring off into the distance. I cried for no reason all the time. I had horrible mood swings. I felt like nobody cared. I couldn't sleep. I felt like I was falling into a dark pit that was totally devoid of light. I felt like life wasn't worth living. I didn't want to go anywhere or do anything or see anyone. I got incredibly angry and frustrated and felt so overwhelmed. This was supposed to be the happiest time in my life and I was wishing I had never been born and that I could just go to sleep and never wake up. The feelings were both intense and lifeless. I don't know how better to describe the fact that I felt such intense emotion and yet felt at the same time that I wasn't feeling anything. 

1.3 million women are feeling like this and their family and friends are dealing with the stress and frustration of it.1,133,334 women and their families are suffering in silence at what should be the happiest  time of their lives and not getting the help they deserve, the help that is out there for them. More than a million women going without help and afraid to say anything. More than a million families struggling to make sense of it. More than a million women wondering "Why bother living? What's the point? Nobody gets it." and some of those women actually will act on it and kill themselves, all for a lack of public awareness and education. More than a million women at risk of committing suicide because they think there's no help for them. Are you still asking what the big deal is?